Arkansas § 5-37-217 - Healthcare fraud.

§ 5-37-217. Healthcare fraud.

As used in this section, “healthcare plan” means a publicly or privately funded program or organization that is formed to provide or pay for healthcare goods or services, including without limitation: Health insurance plans; Managed care organization plans; Risk-based provider plans; The Arkansas Medicaid Program; The Social Security Disability Insurance program; and The Medicare program. A person commits healthcare fraud if, with a purpose to defraud a healthcare plan, the person provides materially false information or omits material information in support of: An application for membership or eligibility for a healthcare plan; A claim for payment or reimbursement as a member or provider in a healthcare plan; or A prior claim for payment or to justify payments previously received from a healthcare plan for healthcare goods or services during the course of an audit or investigation conducted by the Office of Medicaid Inspector General or a healthcare oversight agency with jurisdiction to audit, investigate, or prosecute any form of healthcare fraud. Healthcare fraud is a: Class A misdemeanor if the aggregate amount of the healthcare fraud in any period of twelve (12) months is less than two thousand five hundred dollars ($2,500); Class C felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is two thousand five hundred dollars ($2,500) or more but less than five thousand dollars ($5,000); Class B felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is five thousand dollars ($5,000) or more but less than twenty-five thousand dollars ($25,000); and Class A felony if the aggregate amount of the healthcare fraud in any period of twelve (12) months is twenty-five thousand dollars ($25,000) or more.